Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156F00000X | Technician/Technologist | MTA-0041243 | CA |
NPI | 1043837982 |
---|---|
Provider Name | Abegail M Rabut |
First Address | South San Francisco, CA 94080-2162 |
Second Address | San Francisco, CA 94110-3518 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/06/2020 |
Last Update Date | 26/06/2020 |